To: Editor, The Angle Orthodontist

Re: Extraction vs nonextraction orthodontic treatment: a systematic review and meta-analysis. Karim Gamal Elias, Gautham Sivamurthy, David R. Bearn. The Angle Orthodontist. 2024; 94:83–106.

I congratulate the authors for publishing this work; but note this is yet another systematic review in orthodontic literature concluding that the quality of the included studies is weak and, therefore, there is considerable uncertainty in the findings. Will the authors now pledge to undertake a study to help address this lack of quality data? Without more high-quality primary studies, the publication of this and future reviews will provide little reliable information for evidence-based clinical decision making.

I have made available a protocol here: and welcome anyone to download and adapt it for their own use.

Author notes

Philip Benson Emeritus Professor of Orthodontics, School of Clinical Dentistry, The University of Sheffield, Sheffield, UK